A new concept and policy framework published in PLOS NTDs outlines concrete steps for the global development community as it works to synthesize health goals with economic, environmental and social priorities. The concept, "blue marble health," emphasizes the role of the Group of 20 (G20) nations in tackling neglected tropical diseases (NTDs) to expedite poverty reduction efforts.

"Blue marble health connects countries worldwide by recognizing that extreme poverty is a fundamental underlying factor for neglected tropical diseases (NTDs), regardless of where they occur," said the concept's author, professor Peter Hotez, MD PhD, president of the Sabin Vaccine Institute, director of the Sabin Vaccine Institute and Texas Children's Hospital Center for Vaccine Development and dean of the National School of Tropical Medicine at Baylor College of Medicine. "G20 countries have an exceptional opportunity to embrace NTD control as a cross-cutting strategy and achieve long-lasting, inclusive prosperity within their societies and lower-income countries."

While it is accepted that NTDs affect the world's poorest and most marginalized people living on less than $1.25 a day, the hidden burden of disease among impoverished people in emerging markets and wealthier nations has gone largely unnoticed.

Much of the disease burden within G20 countries falls on marginalized communities in Indonesia and the BRICS (Brazil, Russia, India, China, and South Africa), but there are also several NTDs found in Eastern and Southern Europe, and in the southern United States.

Blue marble health advises the G20 to lead on the following areas:

•Expanding the Portfolio: New information from the Global Burden of Disease Study 2010 highlights the urgency to expand global control and elimination programs to include leishmaniasis, dengue, and food-borne trematode infections.

•Research and Development (R&D): Existing medicines for the seven most common NTDs are safe, effective, and inexpensive. However, new tools and diagnostics will help us stay ahead of how current treatment needs evolve and enable us to address several NTDs for which there are no current options available. G20 countries have an important role to play in investing in R&D, including building up the local capacity of vaccine manufacturers in disease-endemic countries.

•Vaccine Diplomacy: Promoting scientific collaboration between institutions from countries regardless of their ideological perspectives can foster essential dialogue on these life-threatening diseases and lead to new, effective interventions.

•NTD Integration: Strong linkages exist between NTDs and nearly every major development priority. Efforts to control and eliminate should be incorporated into existing programs working to improve maternal and child health; water, sanitation and hygiene; hunger and nutrition; education; and combat HIV/AIDS, tuberculosis and malaria.

•Health of Girls and Women: This population is especially disproportionately affected - indeed NTDs may be the most common afflictions of girls and women living in poverty.

•NCDs: NTDs contribute to a hidden but substantial proportion of the world's non-communicable diseases.

•Sustainable Development Goals (SDGs): Controlling NTDs will serve as a catalyst for the achievement of the Millennium Development Goals and a broad set of issues likely to be addressed in the new SDGs. It will be essential to incorporate NTDs into this framework.

"G20 countries are well-positioned to usher in a new era of enduring economic growth by making the cost-effective investment in people's health. Now is the time to leverage their power and resources to bring about the next wave of successes in NTD control and elimination," said Dr. Hotez.

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